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<div class="content2">
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            <li class="updata"><a href="new-document1.html">个人信息</a></li>
            <li class="on">基本信息</li>
            <li>既往史</li>
            <li>过敏史</li>
            <li>个人史</li>
            <li class="yjs">月经及婚育史</li>
            <li>家族史</li>
            <li>育苗接种记录</li>
            <li class="Chronic1">高血压情况</li>
            <li class="Chronic2">糖尿病情况</li>
            <li class="Chronic3">肺结核情况</li>
            <li class="Chronic4">精神病情况</li>
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            <!--基本信息-->
            <form id="defaultForm2" class="form-horizontal">
                <li class="new-right-show">
                    <div class="new-right-show-n">
                        <ul>
                            <li><div class="new-right-show-n-1-1">姓名:</div><div class="new-right-show-n-1"></div></li>
                            <li><div class="new-right-show-n-1-1">性别:</div><div class="new-right-show-n-2"></div></li>
                            <li><div class="new-right-show-n-1-1">年龄:</div><div class="new-right-show-n-3"></div></li>
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                            <span class="word-1-huan"><b>*</b>医保类型:</span>
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                            <select class="word-yblb form-control"  name="yblx" data-bv-notempty data-bv-notempty-message="">
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                                <option value="1">新农合</option>
                                <option value="2">城镇职工</option>
                                <option value="3">城镇居民</option>
                            </select>
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                        </dt>
                        <div class="word-2-bh">
                            <dt><span class="word-1-huan"><b class="word-l-hua-xinghao">*</b>医保编号:</span>
                            <div class="form-group word-bh1"><input type="text" class="number form-control" value="" name="yibaobianhao"/></div>
                            <div class="form-group word-bh2"><input type="text" class="number2 form-control" value=""/></div>
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                    <dl class="doc-2-left">
                        <dt class="word2-dz">
                            <span class="word-1-huan"><b>*</b>常住地址:</span>
                            <span class="word-1-huan-s"></span>
                        <div class="form-group">
                            <select id="dsheng" name="dsheng" class="form-control" data-bv-notempty data-bv-notempty-message="">
                                <option value="">请选择</option>
                                <option value="460000">海南省</option>
                            </select>
                        </div>
                        <span class="word-1-huan-s"></span>
                        <div class="form-group">
                            <select id="sheng" name="sheng" class="form-control" data-bv-notempty data-bv-notempty-message="">
                                <option value="">请选择</option>
                            </select>
                        </div>
                        <span class="word-1-huan-s"></span>
                        <div class="form-group">
                            <select id="shi" disabled="disabled"  name="shi" class="form-control">
                                <option value="">请选择</option>
                            </select>
                        </div>
                        <div class="form-group">
                            <input type="text" id="changzhu"  class="form-control" name="changzhu">
                        </div>
                        </dt>
                    </dl>
                    <dl class="doc-2-left">
                        <dt class="word2-dz">
                            <span class="word-1-huan">户籍地址:</span>

                            <select id="dsheng2" class="form-control"><!----------1------------->
                                <option value="">请选择</option>
                                <option value="460000">海南省</option>
                            </select>

                            <div class="form-group">
                                <select id="sheng2" class="form-control" name="sheng2"><!-----------2------------>
                                    <option value="">请选择</option>
                                </select>
                            </div>

                            <div class="form-group">
                                <select id="shi2" class="form-control" name="shi2"><!-----------3------------>
                                    <option value="">请选择</option>
                                </select>
                            </div>

                            <div class="form-group">
                                <input type="text" id="huiji" class="form-control"  name="huiji"><!----------4------------->
                            </div>
                        </dt>
                    </dl>
                    <dl class="word-2 doc-2-left">
                        <dt><span class="word-1-huan">职业类别:</span>
                        <div class="form-group">
                            <select  id="zhiye" class="form-control">
                                <option value="">请选择</option>
                                <option value="1">国家机关、党群组织、企业、事业单位负责人</option>
                                <option value="2">专业技术人员</option>
                                <option value="3">办事人员和有关人员</option>
                                <option value="4">商业、服务业人员</option>
                                <option value="5">农、林、牧、渔、水利业生产人员</option>
                                <option value="6">生产、运输设备操作人员及有关人员</option>
                                <option value="7">军人</option>
                                <option value="-1">不便分类的其他从业人员</option>
                            </select>
                         </div>
                        </dt>
                        <div class="word-2-bh">
                            <span class="word-1-huan">工作单位:</span>
                            <div class="form-group"><input type="text" id="work" value="" class="form-control" name="gzdw"/></div>
                        </div>
                    </dl>
                    <dl class="doc-2-left">
                        <dt class="word-2-lx"><span class="word-1-huan"><b>*</b>联系人:</span>
                        <div class="form-group"><input type="text" id="lianxiren" value="" class="form-control" name="lianxiren" /></div>
                        </dt>
                    </dl>
                    <dl class="word-2 doc-2-left">
                        <dt>
                            <span class="word-1-huan"><b>*</b>联系电话:</span>
                        <div class="form-group document-phone">
                            <select id="word-2-tell" class="form-control" name="country" data-bv-notempty
                                    data-bv-notempty-message="">
                                <option value="">请选择</option>
                                <option value="1">手机号码</option>
                                <option value="2">固定电话</option>
                            </select>
                        </div>
                        </dt>
                        <div class="word-2-bh">
                            <div class="form-group"><input type="text" class="word-2-tell2 form-control" value="" name="jbxxphone" required/></div>
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